Baker D G, Mendenhall C L, Simbartl L A, Magan L K, Steinberg J L
Cincinnati Veterans Affairs Medical Center, Ohio, USA.
Arch Intern Med. 1997 Oct 13;157(18):2076-8.
While prior studies show that combat veterans with posttraumatic stress disorder (PTSD) report more physical symptoms than veterans without PTSD, the link between PTSD and somatic complaints in Persian Gulf War veterans (PGWVs) is yet to be evaluated.
A questionnaire booklet was completed by 188 PGWVs, of whom half were patients in a veterans health screening clinic and half were non-treatment-seeking volunteers on active duty. The booklet included the Combat Exposure Scale, the Mississippi Post-Traumatic Stress Disorder Scale (MPTSD), and a subjective symptom-based health questionnaire.
The 24 PGWVs (12.8%) with PTSD (MPTSD score > or = 116) reported more combat exposure (P = .02) and a greater number of physical symptoms (P = .001) than other PGWVs. Fatigue, nausea, muscle aches, dizziness, back pain, stomach ache, and numbness were much more likely to be reported by those with PTSD (MPTSD score > or = 116) than by those without PTSD (MPTSD score < or = 95).
Physicians examining PGWVs should be alert to the possibility of PTSD in this group and that those with PTSD are more likely to report physical symptoms that may overlap with those in Persian Gulf syndrome. Consequently, mental health screening is essential, since for those veterans with PTSD diagnosis of other coexisting conditions may be confounded and early effective treatment of their PTSD may be delayed. Also, given the increased reporting of certain symptoms by those with PTSD, those seeking the cause of Persian Gulf syndrome should control for PTSD when determining the symptom cluster that may constitute this condition.
虽然先前的研究表明,患有创伤后应激障碍(PTSD)的退伍军人比没有PTSD的退伍军人报告更多的身体症状,但PTSD与海湾战争退伍军人(PGWVs)躯体主诉之间的联系尚未得到评估。
188名PGWVs完成了一本问卷手册,其中一半是退伍军人健康筛查诊所的患者,另一半是现役非寻求治疗的志愿者。该手册包括战斗暴露量表、密西西比创伤后应激障碍量表(MPTSD)和一份基于主观症状的健康问卷。
24名患有PTSD(MPTSD评分≥116)的PGWVs(12.8%)比其他PGWVs报告了更多的战斗暴露(P = 0.02)和更多的身体症状(P = 0.001)。与没有PTSD(MPTSD评分≤95)的人相比,患有PTSD(MPTSD评分≥116)的人更有可能报告疲劳、恶心、肌肉疼痛、头晕、背痛、胃痛和麻木。
检查PGWVs的医生应警惕该群体中PTSD的可能性,并且患有PTSD的人更有可能报告与海湾战争综合征可能重叠的身体症状。因此,心理健康筛查至关重要,因为对于那些患有PTSD的退伍军人,其他并存疾病的诊断可能会混淆,其PTSD的早期有效治疗可能会延迟。此外,鉴于患有PTSD的人对某些症状的报告增加,寻求海湾战争综合征病因的人在确定可能构成这种疾病的症状群时应控制PTSD因素。